NPIMap

Organization Active NPI

Elisa/Act Biotechnologies LLC

  • Clinical Medical Laboratory
  • Sterling, VA
National Provider Identifier
1104868512
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ELISA/ACT BIOTECHNOLOGIES LLC
Practice address
14 Pidgeon Hill Dr
Suite 300
Sterling, VA 20165-6155
Phone
(703) 788-5101
Fax
(703) 450-2981
NPI assigned
Jun 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Russell Merrit Jaffe, MDNPI 1114122371
Title
President/ Ceo
Phone
(703) 788-5111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X VA Primary

Addresses

Primary practice location

14 Pidgeon Hill Dr
Suite 300
Sterling, VA 20165-6155

Mailing address

14 Pidgeon Hill Dr
Suite 300
Sterling, VA 20165-6155
Phone (703) 788-5101

National Provider Directory

National Provider Directory
Tax ID family
Elisaact Biotechnologies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14 Pidgeon Hill Dr
Ste 300
Sterling, VA 20165
Phone (703) 450-2980

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104868512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PIDGEON HILL DR",
            "address_2": "SUITE 300",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656155",
            "telephone_number": "703-788-5101",
            "fax_number": "703-450-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PIDGEON HILL DR",
            "address_2": "SUITE 300",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656155",
            "telephone_number": "703-788-5101",
            "fax_number": "703-450-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISA/ACT BIOTECHNOLOGIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "MERRIT",
        "authorized_official_title_or_position": "PRESIDENT/ CEO",
        "authorized_official_telephone_number": "703-788-5111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.